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Chateau DuBois/DOCS/$94,500 Chateau DuBois DOCS 2011 Appropriation #43- 504 -00; P.O. #27213 Contract Not To Exceed $94,500.00 ADDITIONAL SERVICES AMENDMENT TO tl A AGREEMENT FOR PURCHASE OF GOODS AND SERVICES \CI THIS AMENDMENT TO THE GOODS AND SERVICES AGREEMENT "Agreement entered into by and between the City of Carmel and Chateau DuBois (the "Vendor as City Contract 10.20.10.02 shall amend the terms of the Agreement by adding the additional services to be provided by Vendor consistent with the Scope of Work attached hereto and incorporated herein as Exhibit "A The terms and conditions of the Agreement shall not otherwise be affected by his Additional Services Amendment and shall remain in full force and effect. IN WITNESS WHEREOF, the parties hereto have made and executed this Amendment as follows: CITY OF CARMEL, INDIANA CHATEAU DuBOIS by and through its Board of Public Works and Safety By: 1 By: J9 es Brainars, Presiding Offic Author(gJg.nat e D.te: Printed Name Ma An I.urke, Me ber Date: C J/ c (._,Y I c'.,t\ Title 35 g Lori S. Wats Member FID/TIN: Date: 4,/ Last Four of SSN if Sole Proprietor: ATTEST: 1,)..1 Date: ,I LAO 1 Cordray, IAMC clerk- Treasurer gate: /p [\4ssvrapps1 \uca data aih 0 i,,r l\Prol.Svcs S Goods Svc. \DOCS \CHATEAU DcBOIS Add'I Svcs Arnold Gods Savicv' 5 -19 -2011 da::5 /19/2011 9:45 AM] re 6i O C CITY DF ARMEL JAMES BRAINARD, MAYOR May 18, 2011 Chateau DuBois P.O. Box 262 Westfield, IN 46074 Re: Additional Professional Services #1 (P.O. 27213) Dear Ms. DuBois: The City of Carmel has a need for additional professional services over and above those set out in the Agreement for Purchase of Goods and Services between the City of Carmel and Kingswood Farms., dated October 20, 2010, (Contract 10.20.10.02) I have requested and received from you the proposed scope of services and fee estimate for the following services: Additional Services #1: Extension of current contract Not to Exceed: $94,500.00 #10.20.10.02 Per our procedural requirements, I hereby approve this "Additional Professional Services" estimate, and grant you the Notice to Proceed for the above services. PLEASE NOTE: Be advised that "Additional Professional Services" performed through agreement with the City of Carmel must be billed separately from the original Agreement and other additional services. More importantly, the invoice must reference "Additional Services #1" and include Purchase Order #27213.. Invoices submitted without this information will be returned to your office. Thank you for your continued assistance in providing the City of Carmel with your professional, quality services. If you should have any questions, please give me a call. Sincerely, o Michael P. Hollibaugh Director Reviewed and approved by: cc: Mayor James Brainard y Diana Cordray, Clerk Treasurer Cindy Sheeks Steve Engelking Director of Administration Exhibit A DEPARTMENT OF COMMUNITY SERVICES ONE CIVIC SQUARE, CARMEL, IN 46032 PHONE 317.571.2417, FAX 317.571.2426 MICHAEL. P. HOLLII3AUGI I, DIRECTOR C ltY i 1Jlr C INDIANA RETAIL TAX EXEMPT PAGE CERTIFICATE NO. 003120155 002 0 PURCHASE ORDER NUMBER FEDERAL EXCISE TAX EXEMPT 12a 1 3 35- 60000972 ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES, A/P CARMEL, INDIANA 46032 -2584 VOUCHER, DELIVERY MEMO, PACKING SLIPS, SHIPPING LABELS AND ANY CORRESPONDENCE. FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL 1997 bURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION 1 CH Tent. 4 &/s L £lt) filr Vii) VENDOR t?. 66 `e SHIP a l D bO n,,/ s iet TO ©�l�W CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT X QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION /9016 i 69 Vi c S L? A i 94 B-d st_iffv41P1 01- Ca ir OF C 4 z:;?' yi A /..0 :,:s2 .:0 4 41,),:i —4 II A,. ti III e 4. a Send Invoice To: y PI 4 -4 ter. /0 .4()C-S J8-604- 0-0 191u eivio z C g L PLEASE INVOICE IN DUPLICATE DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT PAYMENT A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O. NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND VOUCHER HAS THE "ROPER SWORN AFFIDAVIT ATTACHED. SHIPPING INSTRUCTIONS I HEREBY CERTI AT ,i: IS AN UNOBLIGATED BALANCE IN THIS APPROPR d o 'i FICIENT TO P• FOR THE ABOVE ORDER. SHIP REPAID. C.O.D. SHIPMENTS CANNOT BE ACCEPTED. to PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY SHIPPING LABELS. ./1*---"-•""i THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. 27213 CLERK TREASURER DOCUMENT CONTROL NO. VENDOR COPY